Advertisement

Generic Name:

linagliptin-metformin, Oral tablet

Generic Name:
Jentadueto,Jentadueto XR

linagliptin-metformin, Oral tablet

All Brands

  • Jentadueto
  • Jentadueto XR
SECTION 1 of 4

Highlights for linagliptin-metformin

Oral tablet
1

This is a combination product that contains linagliptin and metformin. It is available under the brand name Jentadueto. It is not available in a generic version.

2

This medication is used along with diet and exercise to improve control of blood sugar levels in adults with type 2 diabetes. It should not be used to treat type 1 diabetes or a condition called ketoacidosis.

3

This drug is available as a tablet and extended-release tablet (a drug that’s released slowly into your body over time) you take by mouth.

4

You should not take this drug if your kidneys do not work well. Metformin levels can increase in your blood and cause dangerous side effects.

5

The use of metformin can lead to a rare but serious condition called lactic acidosis (a buildup of lactic acid in your blood). If not treated, it can lead to death.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to drug effects that may be dangerous.

Lactic acidosis warning. Metformin, one of the medications in this combination drug, can cause a rare but serious condition. It is called lactic acidosis (a buildup of lactic acid in the blood). If not treated, it can lead to death.

The risk of lactic acidosis increases with certain factors. These include dehydration (not drinking enough water), surgery, and having too many drinks that contain alcohol. They also include liver or kidney problems, and certain types of heart disease, such as congestive heart failure that gets abruptly worse.

Inflammation of the pancreas (pancreatitis)

Linagliptin, one of the medications in this combination drug, may cause a sudden inflammation of your pancreas. Tell your doctor if you have sudden pain in your stomach area that travels to your back, a swollen or tender stomach area, or nausea and vomiting.

Surgery

Having surgery can increase your risk of lactic acidosis. This is a rare but serious condition that is linked with metformin, one of the medications in this combination drug. Lactic acidosis is a buildup of lactic acid in the blood. If not treated, it can lead to death. To reduce your risk, your doctor may decrease or stop your use of this medication before surgery. Your doctor may restart the medication after the surgery.

Tests that use radiocontrast dye

Your doctor will stop your use of this medication if you have an x-ray test that uses dye or contrast. This dye can change how your kidneys work, which could increase your risk of lactic acidosis. This is a rare but serious condition that can lead to death if not treated.

What is linagliptin-metformin?

This product is a prescription medication that contains two drugs: linagliptin and metformin. It is important to know about all the drugs in the combination because each drug may affect you in a different way.

This combination drug may also be used as part of a combination therapy. That means you may need to take it with other drugs.

This drug comes in the form of a tablet and an extended-release tablet that you take by mouth. It’s available under the brand name Jentadueto. It is not available in a generic form.

Why it's used

This linagliptin and metformin combination product is prescribed to treat type 2 diabetes in adults. It is used along with diet and exercise to help improve blood sugar levels.

How it works

This is a combination of two drugs in a single tablet. The drugs are linagliptin and metformin.

More Details

How it works

This is a combination of two drugs in a single tablet. The drugs are linagliptin and metformin. It is important to know about all the drugs in the combination because each drug may affect you in a different way.

Linagliptin belongs to a class of drugs called dipeptidyl-peptidase-4 (DPP-4) inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Linagliptin increases the amount of insulin your body makes. (Insulin is a substance that helps move sugar from your bloodstream into your body’s cells.) Linagliptin also lowers the amount of sugar (glucose) your body makes. These steps lower your blood sugar level.

Metformin belongs to a class of drugs called biguanides. Metformin slows down the amount of glucose your liver makes. It also lowers the amount of glucose absorbed by your body, and improves how well your body uses insulin. All of these steps help lower your blood sugar level.

Advertisement
SECTION 2 of 4

linagliptin-metformin Side Effects

Oral tablet

Most Common Side Effects

Some of the more common side effects that can occur with use of this combination product include:

  • cold-like symptoms (stuffy or runny nose, sore throat, cough)

  • diarrhea

  • decreased appetite

  • nausea or vomiting

  • itching

These side effects may be mild and go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have any of these serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

  • Lactic acidosis. Symptoms can include:

    • extreme weakness or tiredness
    • unusual muscle pain
    • trouble breathing
    • unexplained stomach pains with nausea, vomiting, and diarrhea
    • cold feeling in arms and legs
    • slow or irregular heartbeat

    If you have any of these symptoms, stop taking this medication and go to the emergency room right away.

  • Low blood sugar (hypoglycemia). Symptoms can include:

    • shaking or jittery feeling
    • sweating
    • fast heartbeat
    • change in vision
    • dizziness
  • Allergic reactions. Symptoms can include:

    • swelling of face, lips, or throat
    • trouble swallowing or breathing
    • skin rash
    • hives (raised, itchy bumps)
  • Inflammation of the pancreas (pancreatitis). Symptoms can include:

    • sudden pain in stomach area that travels to your back
    • swollen and tender stomach area
  • Low vitamin B12 levels. Symptoms can include:

    • tiredness
    • memory problems
    • trouble with balance

    Low levels of vitamin B12 can lead to low levels of red blood cells and hemoglobin in the blood. This condition is called anemia. Your risk of these problems increases with long-term metformin therapy (3 or more years). It also increases if you do not get enough vitamin B12 or calcium from the foods you eat.

  • severe joint pain

Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

If you have a low blood sugar reaction, you need to treat it:

  • For mild hypoglycemia (55–70 mg/dL), treatment is 15–20 grams of glucose (a type of sugar). You need to eat or drink one of the following:
    • 3–4 glucose tablets
    • a tube of glucose gel
    • ½ cup of juice or regular, non-diet soda
    • 1 cup of nonfat or 1% cow’s milk
    • 1 tablespoon of sugar, honey, or corn syrup
    • 8–10 pieces of hard candy, such as lifesavers
  • Test your blood sugar 15 minutes after you treat the low sugar reaction. If your blood sugar is still low, repeat the above treatment.
  • Once your blood sugar is back in the normal range, eat a small snack if your next planned meal or snack is more than 1 hour later.

If you don’t treat low blood sugar, you can have a seizure, pass out, and possibly develop brain damage. Low blood sugar can even be fatal. If you pass out because of a low sugar reaction or cannot swallow, someone will have to give you an injection of glucagon to treat the low sugar reaction. You may need to go to the emergency room.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

linagliptin-metformin May Interact with Other Medications

Oral tablet

The linagliptin and metformin in this combination drug product can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. To help avoid interactions, your doctor should manage all of your medications carefully. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol interaction

Avoid drinking alcohol while you take this drug. This drug contains metformin. Drinking alcohol while taking this drugs that contain metformin raises your risk of lactic acidosis. This condition is rare but serious. If lactic acidosis is not treated, it can lead to death.

Medications that might interact with this drug

Antibiotics

Certain antibiotics can increase the amount of metformin in your body. This could cause unwanted side effects and increase the risk of lactic acidosis. This is a rare but serious condition that can lead to death. These drugs include:

  • vancomycin
  • trimethoprim

The following antibiotic can prevent linagliptin from working:

  • rifampin

It should not be used with this combination drug product.

Asthma drugs

Terbutaline is an asthma drug that can increase your blood sugar levels. This can cause problems with diabetes control while you take this linagliptin and metformin combination product.

Blood sugar drugs

These drugs can lower blood sugar levels. Using them together with this combination product can cause your blood sugar level to drop too low. The doses of these drugs may need to be decreased when taken with this medication. This can help reduce the risk of a low blood sugar reaction. Your doctor can tell you more.

These drugs include:

  • glipizide
  • glyburide
  • nateglinide
  • repaglinide
  • insulin

Cholesterol drugs

Niacin is a cholesterol drug that can increase your blood sugar levels. This can cause problems with diabetes control while you take this linagliptin and metformin combination product.

Heart drugs

Certain heart drugs can increase the amount of metformin in your body. This could cause unwanted side effects and increase the risk of lactic acidosis. This is a rare but serious condition that can lead to death. These drugs include:

  • amiloride
  • digoxin
  • riamterene
  • quinidine
  • procainamide

Also, certain heart drugs can increase your blood sugar levels. This can cause problems with diabetes control while you take this linagliptin and metformin combination product. These drugs include:

  • hydrochlorothiazide
  • calcium channel blockers, such as:
    • amlodipine
    • verapamil

Heartburn drugs

Certain heartburn drugs can increase the amount of metformin in your body. This could cause unwanted side effects and increase the risk of lactic acidosis. This is a rare but serious condition that can lead to death. These drugs include:

  • cimetidine
  • ranitidine

Nasal congestion drugs

Some of these drugs can increase your blood sugar levels. This can cause problems with diabetes control while you take this linagliptin and metformin combination product. These drugs include:

  • pseudoephedrine
  • naphazoline

Oral contraceptive drugs and estrogens

These drugs can increase your blood sugar levels. This can cause problems with diabetes control while you take this linagliptin and metformin combination product. These drugs include:

  • oral contraceptives that contain ethinyl estradiol
  • conjugated estrogens (Premarin)

Pain drugs

Morphine, a type of pain drug, can increase the amount of metformin in your body. This could cause unwanted side effects and increase the risk of lactic acidosis. This is a rare but serious condition that can lead to death.

Seizure drugs

Zonisamide is a seizure drug that can increase the risk of lactic acidosis linked with metformin. This is a rare but serious condition that can lead to death.

Phenytoin, another seizure drug, can increase your blood sugar levels. This can cause problems with diabetes control while you take this linagliptin and metformin combination product. 

Seizure and migraine drugs

Topiramate, a drug that can be used to treat seizures or migraines, can increase the risk of lactic acidosis linked with metformin. This is a rare but serious condition that can lead to death.

Thyroid drugs

Certain thyroid drugs can increase your blood sugar levels. This can cause problems with diabetes control while you take this linagliptin and metformin combination product. These drugs include:

  • levothyroxine
  • liotrix
  • liothyronine
  • desiccated thyroid

Tuberculosis drugs

Isoniazid is a tuberculosis drug that can increase your blood sugar levels. This can cause problems with diabetes control while you take this linagliptin and metformin combination product.

Drugs for glaucoma, seizures, and edema

Drugs used to treat glaucoma, seizures, and fluid build-up (edema), such as acetazolamide, can increase the risk of lactic acidosis linked with metformin. This is a rare but serious condition that can lead to death.

Drugs to treat allergic reactions or low blood pressure

Some of these drugs can increase your blood sugar levels. This can cause problems with diabetes control while you take this linagliptin and metformin combination product. These drugs include:

  • epinephrine
  • dopamine

Other drugs

Certain drugs can increase your blood sugar levels. This can cause problems with diabetes control while you take this linagliptin and metformin combination product. These drugs include:

  • corticosteroids, such as:
    • methylprednisolone
    • prednisone

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Linagliptin and metformin warnings
kidney disease
People with kidney disease

Metformin is one of the medications in this combination drug product. If you have poor kidney function, you should not take metformin. This is because levels of metformin can build up in your blood if your kidneys are not working well. This can cause dangerous side effects.

liver problems
People with liver problems

Metformin is one of the medications in this combination drug product. Using metformin when you have liver damage can increase your risk of lactic acidosis. This is a rare but serious condition that can lead to death if not treated. Your doctor will test your liver function before and during your treatment with this medication.

vitamin b12
People with low levels of vitamin B12

Metformin is one of the medications in this combination drug product. The use of metformin can lower the levels of vitamin B12 in your blood. If you already have low levels of vitamin B12 or have anemia (low levels of red blood cells), these conditions can get worse.

Your doctor will monitor your vitamin B12 levels at least once a year. If you have low levels, you will be tested or monitored for anemia. This is because low levels of B12 can cause anemia. You may need to have a vitamin B12 injection.

pancreatitis
People with pancreatitis

Linagliptin is one of the medications in this combination drug product. The use of linagliptin may cause a sudden inflammation of your pancreas (pancreatitis). It can also worsen this condition if you already have it.

You should not use this product if you are having an episode of pancreatitis. If you may have pancreatitis, you should stop taking this medication. You should be tested for pancreatitis and treated, if needed.

heart disease
People with heart disease

Metformin is one of the medications in this combination drug product. When you have certain heart conditions, using metformin can increase your risk of lactic acidosis. These conditions include congestive heart failure and heart attack. Lactic acidosis is a rare but serious condition. If not treated, it can lead to death. Your doctor can tell you more.

alcohol use disorder
People with alcohol use disorder

If you have alcohol use disorder, you should not use this drug. This drug contains metformin. Drinking alcohol while taking drugs that contain metformin increases your risk of lactic acidosis. This is a rare but serious condition. If lactic acidosis is not treated, it can lead to death.

Pregnant women
Pregnant women

This linagliptin and metformin combination product is a pregnancy category B drug. That means two things:

  1. Research in animals has not shown a risk to the fetus when the mother takes the drug.
  2. There aren’t enough studies done in humans to show if the drug poses a risk to the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. Animal studies do not always predict the way humans would respond. Therefore, this drug should only be used in pregnancy if clearly needed.

breast-feeding
Women who are breast-feeding

It is not known if this linagliptin and metformin combination product passes into breast milk. Metformin alone appears in breast milk in small amounts. This drug can lower blood sugar levels. So, this combination product may cause low blood sugar in your baby if you breastfeed.

Talk to your doctor if you are breastfeeding. You should decide together if you should stop taking this drug or stop breastfeeding.

For seniors
For seniors

If you are 80 years old or older, your doctor will test your kidney function before and during treatment with this medication. This is because seniors are more likely to have decreased kidney function. If you have kidney disease, you should not take metformin (one of the drugs in this combination product).

Also, your body may process this medication more slowly. Your doctor may monitor you closely to see if this drug is lowering your blood sugar too much.

When to call the doctor
When to call the doctor

If you notice that your blood sugar level is not controlled after using this drug for 1–2 weeks, call your doctor.

Allergies
Allergies

Linagliptin, one of the medications in this combination drug product, can cause a severe allergic reaction. Symptoms can include:

  • swelling of lips, throat, or face
  • trouble breathing or swallowing
  • raised, red areas on your skin (hives)
  • skin problems (including itching, flaking, peeling or rash)

If you have an allergic reaction, call your doctor right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug if you have ever had an allergic reaction to linagliptin before. Taking it a second time after any allergic reaction to it could lead to death.

SECTION 4 of 4

How to Take linagliptin-metformin (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your doctor will tell you what dosage is right for you. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Type 2 diabetes

Brand: Jentadueto

Form: Oral tablet
Strengths:
  • linagliptin 2.5 mg/metformin 500 mg
  • linagliptin 2.5 mg/metformin 850 mg
  • linagliptin 2.5 mg/metformin 1,000 mg
Form: Extended-release oral tablet
Strengths:
  • linagliptin 2.5 mg/metformin 1,000 mg
  • linagliptin 5 mg/ metformin 1000 mg
Adult dosage (ages 18–64 years)
  • Your doctor may start you with a lowered dose of one tablet of 2.5 mg of linagliptin and 500 mg of metformin, once per day, to prevent stomach upset.
  • After 35 days, your doctor may have you take this tablet twice per day.
  • After a few weeks, your doctor may slowly increase your dosage. This depends on how well the medication controls your blood sugar level.
  • The highest dosage recommended for these medications is 5 mg of linagliptin and 2,000 mg of metformin per day.
Child dosage (ages 0–17 years)

This medication has not been studied in children. It should not be used in anyone younger than 18 years.

Senior dosage (ages 65 years and older)

Your body may process this drug more slowly. Your doctor may start you on a lowered dose to keep the drug from building up too much in your body. Too much of the drug in your body can be dangerous.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This linagliptin and metformin combination product comes with serious risks if you don't take it as prescribed.

If you stop taking the drug suddenly or don't take it at all

Your blood sugar level will likely rise. If your blood sugar level is high and not controlled for a long time, you can have serious complications. These include a condition called diabetic ketoacidosis. This can be fatal (cause death).

You will also be at higher risk for long-term complications from diabetes. These can be disabling or life-threatening. They include problems with your nerves, eyes, kidneys, feet, and skin. They also include heart and blood vessel disease.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. In order for this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You may have a low blood sugar reaction (hypoglycemia). If you do, you need to treat the reaction:

  • For mild hypoglycemia (55–70 mg/dL), treatment is 15–20 grams of glucose (a type of sugar). You need to eat or drink one of the following:
    • 3–4 glucose tablets
    • a tube of glucose gel
    • ½ cup of juice or regular, non-diet soda
    • 1 cup of nonfat or 1% cow’s milk
    • 1 tablespoon of sugar, honey, or corn syrup
    • 8–10 pieces of hard candy, such as lifesavers
  • Test your blood sugar 15 minutes after you treat the low sugar reaction. If your blood sugar is still low, repeat the above treatment.
  • Once your blood sugar is back in the normal range, eat a small snack if your next planned meal or snack is more than 1 hour later. 

If you don’t treat low blood sugar, you can have a seizure, pass out, or possibly develop brain damage. Low blood sugar can even be fatal. If you pass out because of a low sugar reaction or cannot swallow, someone will have to give an injection of glucagon to treat the low sugar reaction. You may need to go to the emergency room.

If you think you’ve taken too much of this drug, call your doctor or local Poison Control Center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

What to do if you miss a dose

Take it as soon as you remember. But if you remember just a few hours before the time for your next dose, then only take one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

Your doctor may have you check your blood sugar each day using a blood glucose meter. Your doctor will tell you where to get this device and how to use it. Also, about four times each year, your doctor will do a blood test. This is called an A1C test (HgbA1C).

If this drug is working, these tests will show that your blood sugar level has lowered to a number within a certain range. Your doctor will tell you what range is best for you.

This linagliptin and metformin combination product is a long-term drug treatment.

You can take this drug with food

Taking this drug with food helps to prevent an upset stomach.

This drug must be stored at the right temperature

Store your linagliptin and metformin combination tablets at room temperature between 68°F (20°C) and 77°F (25°C). If needed, they can be kept for a short time at temperatures of 59–86°F (15–30°C).

Don’t store this medication in moist or damp areas, such as bathrooms. 

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Be sure to carry with you the prescription-labeled box that your medication came in.
  • Do not put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the temperature outside is very hot or very cold.

Self-management

Your doctor may have you test your blood sugar (glucose) level with a home blood glucose meter. By checking your blood sugar level at home, you will be able to tell if it is within the correct range for you.

You may need to buy the following items to help you monitor your blood sugar level:

  • sterile alcohol wipes
  • lancing device and lancets (pricking needles used to draw a drop of blood for testing)
  • blood glucose test strips
  • a blood glucose meter
  • a sharps container (a bin for safe disposal of used lancets)

Your doctor will tell you what to do if your blood sugar level is too low or high. Your doctor will also have you log your home blood sugar testing results. Based on your results, your doctor may decide to adjust your diabetes medication.

Clinical monitoring

You will need to have your blood sugar level monitored while you take this linagliptin and metformin combination product. This will help make sure your level is within the range your doctor feels is best for you. It will also check if your medication is working.

This monitoring may be done using two tests:

  • Blood sugar level. Your doctor may tell you to check your blood sugar level each day using a blood glucose meter. Your doctor will tell you where to get this device and how to use it.
  • A1C test (HgbA1C). Your doctor will do this blood test about four times each year.

Your doctor may also do blood tests to check if it is safe to start or to continue taking this medication. The tests may include:

  • kidney function tests (blood creatinine levels and/or creatinine clearance)
  • liver function tests
  • eye exam (at least once a year)
  • foot exam (at least once a year)
  • dental exam (at least once a year)
  • tests for nerve damage
  • test to check cholesterol levels
  • tests to check blood pressure and heart rate
  • blood test to check your levels of vitamin B12
  • complete blood count to check for anemia

Your diet

Metformin, one of the drugs in this combination product, can decrease the levels of vitamin B12 in your blood. Be sure to eat enough foods that provide vitamin B12 or calcium. Foods that contain both of these nutrients include milk, cheese, and yogurt.

Not every pharmacy stocks this drug

When filling your prescription, be sure to call ahead.

Hidden costs

If your doctor tells you to monitor your blood sugar level at home, you will need to purchase:

  • sterile alcohol wipes
  • lancing device and lancets (pricking needles used to draw a drop of blood for testing)
  • a blood glucose meter
  • blood glucose test strips
  • a sharps container (a bin for safe disposal of used lancets)

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription. Your insurance company may require you to take each drug in this combination product alone before you can switch to the combination tablet.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other options that may work for you.


Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on July 6, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Advertisement
Advertisement
Advertisement